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Cardiovascular, metabolic, and hormonal responses to noradrenaline in diabetic patients with autonomic neuropathy.
Diabet Med. 1996 Nov; 13(11):983-9.DM

Abstract

Denervation hypersensitivity is a well-known phenomenon in patients with autonomic failure. In diabetic autonomic neuropathy hypersensitivity to beta-adrenergic stimulation has been demonstrated. We infused noradrenaline, mainly an alpha-adrenoceptor agonist, in three escalating doses (0.5, 2.5, and 5 micrograms min-1) in three age and sex matched groups of eight subjects: healthy volunteers, diabetic patients with and without autonomic neuropathy. During steady state in each infusion period we measured heart rate, blood pressure, cardiac output, hepato-splanchnic blood flow, vascular resistance, glucose kinetics, metabolites (beta-hydroxybuturate, glycerol, and lactate), and glucoregulatory hormones (noradrenaline, adrenaline, growth hormone, pancreatic polypeptide, cortisol, and insulin). Systolic and mean blood pressure increased in all groups but diabetic patients with autonomic neuropathy showed a significantly higher increase (p < 0.01) than the other two groups, with a lower threshold for increase in blood pressure. Cardiac output, hepato-splanchnic blood flow, vascular resistance, and heart rate did not change in any of the groups. The incremental increase in glucose and beta-hydroxybuturate was higher in patients with autonomic neuropathy. Otherwise, only minor changes were seen in hormonal and metabolic parameters. The cardiovascular hypersensitivity seen in diabetic autonomic neuropathy was mainly explained by increased peripheral vascular resistance, which increased significantly (p < 0.05) more in these patients. In conclusion, diabetic patients with autonomic neuropathy show denervation hypersensitivity to alpha-adrenergic stimulation by noradrenaline, especially as regards cardiovascular effects.

Authors+Show Affiliations

Dejgaard A
Hvidoere Hospital, Klampenborg, Denmark.
Andersen P
No affiliation info available
Hvidberg A
No affiliation info available
Hilsted J
No affiliation info available

MeSH

3-Hydroxybutyric AcidAdrenergic alpha-AgonistsAdultBlood GlucoseBlood PressureCardiac OutputDiabetes Mellitus, Type 1Diabetic NeuropathiesEpinephrineFemaleGlycerolHeart RateHemodynamicsHormonesHuman Growth HormoneHumansHydrocortisoneHydroxybutyratesInfusions, IntravenousInsulinLactatesMaleMiddle AgedNorepinephrinePancreatic PolypeptideReference ValuesSplanchnic CirculationVascular Resistance

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

8946158

Citation

Dejgaard, A, et al. "Cardiovascular, Metabolic, and Hormonal Responses to Noradrenaline in Diabetic Patients With Autonomic Neuropathy." Diabetic Medicine : a Journal of the British Diabetic Association, vol. 13, no. 11, 1996, pp. 983-9.
Dejgaard A, Andersen P, Hvidberg A, et al. Cardiovascular, metabolic, and hormonal responses to noradrenaline in diabetic patients with autonomic neuropathy. Diabet Med. 1996;13(11):983-9.
Dejgaard, A., Andersen, P., Hvidberg, A., & Hilsted, J. (1996). Cardiovascular, metabolic, and hormonal responses to noradrenaline in diabetic patients with autonomic neuropathy. Diabetic Medicine : a Journal of the British Diabetic Association, 13(11), 983-9.
Dejgaard A, et al. Cardiovascular, Metabolic, and Hormonal Responses to Noradrenaline in Diabetic Patients With Autonomic Neuropathy. Diabet Med. 1996;13(11):983-9. PubMed PMID: 8946158.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cardiovascular, metabolic, and hormonal responses to noradrenaline in diabetic patients with autonomic neuropathy. AU - Dejgaard,A, AU - Andersen,P, AU - Hvidberg,A, AU - Hilsted,J, PY - 1996/11/1/pubmed PY - 1996/11/1/medline PY - 1996/11/1/entrez SP - 983 EP - 9 JF - Diabetic medicine : a journal of the British Diabetic Association JO - Diabet Med VL - 13 IS - 11 N2 - Denervation hypersensitivity is a well-known phenomenon in patients with autonomic failure. In diabetic autonomic neuropathy hypersensitivity to beta-adrenergic stimulation has been demonstrated. We infused noradrenaline, mainly an alpha-adrenoceptor agonist, in three escalating doses (0.5, 2.5, and 5 micrograms min-1) in three age and sex matched groups of eight subjects: healthy volunteers, diabetic patients with and without autonomic neuropathy. During steady state in each infusion period we measured heart rate, blood pressure, cardiac output, hepato-splanchnic blood flow, vascular resistance, glucose kinetics, metabolites (beta-hydroxybuturate, glycerol, and lactate), and glucoregulatory hormones (noradrenaline, adrenaline, growth hormone, pancreatic polypeptide, cortisol, and insulin). Systolic and mean blood pressure increased in all groups but diabetic patients with autonomic neuropathy showed a significantly higher increase (p < 0.01) than the other two groups, with a lower threshold for increase in blood pressure. Cardiac output, hepato-splanchnic blood flow, vascular resistance, and heart rate did not change in any of the groups. The incremental increase in glucose and beta-hydroxybuturate was higher in patients with autonomic neuropathy. Otherwise, only minor changes were seen in hormonal and metabolic parameters. The cardiovascular hypersensitivity seen in diabetic autonomic neuropathy was mainly explained by increased peripheral vascular resistance, which increased significantly (p < 0.05) more in these patients. In conclusion, diabetic patients with autonomic neuropathy show denervation hypersensitivity to alpha-adrenergic stimulation by noradrenaline, especially as regards cardiovascular effects. SN - 0742-3071 UR - https://www.unboundmedicine.com/medline/citation/8946158/Cardiovascular_metabolic_and_hormonal_responses_to_noradrenaline_in_diabetic_patients_with_autonomic_neuropathy_ L2 - https://medlineplus.gov/hormones.html DB - PRIME DP - Unbound Medicine ER -